| NPI | 1043558539 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NC 5008764) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5008764) |
| 363LF0000X Nurse Practitioner, Family (Licence: MD Ac001101) | |
| Enumeration Date | 2013-01-18 |
| Last Update Date | 2023-01-30 |